My friend’s daughter just moved in with a recovering addict. The bf is 18 or 20, I’m not sure but young.
Her other daughter took some things over to drop off and since they weren’t home she let herself in. She found the place to be a mess with syringes and empty capsules laying all over the place. Obviously this is a concern for my friend. Especially since her daughter is pregnant and due in about 2 weeks.
According to the daughter and her bf, his grandfather brings him his dose of methadone each morning and he injects it subq under his tongue.
My friend asked me about that and I said it doesn’t sound right to me. Every recovering addict I’ve known drank their methadone. Also, they had to go to the clinic every day to get their dose and they had to take it there at the clinic while somebody watched them.
I’ve tried looking it up online, it’s been at least 20 years since I’ve been around anybody taking methadone and I’m sure things have changed. However, I don’t know how or why any subq injection would go under a tongue. From everything I’m reading it would be very dangerous to inject methadone anyway. From everything I’m reading subq injections go into fatty areas.
I asked my friend to see if it’s syringes only or if there are needles as well because maybe he is squirting the methadone under his tongue. Could that be the way he is taking it?
The only people I’ve ever known to inject anything under their tongue were hard core addicts who were running out of places to shoot up.
Supposedly the empty capsules contain medicine to help him gain weight. He empties the capsules and puts them back together. Sounds weird to me.
How likely is it that the bf is telling the truth?
My friend is just about ready to grab her daughter and drag her home. It doesn’t sound like a good environment for a baby.
And that. I know a fair number of recovering heroin addicts who’ve gone the methadone route, and this is still how it’s done. Dosing is done in person, supervised, daily, so that there’s zero chance of stockpiling or diverting.
While weekly take-homes are common, they don’t happen until the client has shown himself to be reliable and responsible for himself. If this guy needs to have his take-homes monitored by someone else then the clinic probably doesn’t know about it and he’s being dishonest somewhere along the line. Not good news, I’m afraid.
Weighing in as a physician with a LOT of Addiction Medicine training; the smart money is on rampant drug abuse going on in the household, not legitimate methadone maintenance treatment. Because what’s described in no way resembles legitimate treatment.
Methadone is administered orally. An addict in treatment has to show up at the clinic daily and take it under supervision. It’s given in a liquid because that’s a lot harder to fake swallowing or hold in the mouth.
After demonstrating trustworthiness - which, in real life, might never happen - an addict will be allowed take-home bottles. Back when I was working at a clinic that started with single doses and eventually could be ramped up to two-weeks supply at a time, but the latter was quite rare (we had it for an addict in hospice who physically couldn’t get to the clinic, for example, and another who had been stable on methadone since the 1970’s and held down a full time job, no legal problems for decades, etc.)
The situation described in the OP indicates drug abuse still continuing and an addict concocting a bullshit story to cover that use. An addict serious about recovering will not have syringes all over the place. There’s no damn good reason to empty a capsule of its contents, much less have the empties lying around.
Thank all of you for the answers. I thought it was BS but I’m not an expert so what do I know?
I don’t know if my friend’s daughter knows the truth and is covering for her bf or if she doesn’t know any better either. I suspect the former.
My friend found empty capsules in her daughters room months ago. She and her husband called a family meeting with included this boy’s family. Both his father and grandfather said the capsules contained a drug to help him gain weight. I suppose it would make sense to open the capsule if you have trouble swallowing pills, but it does not make sense to keep the empty capsules and put them back together. I wonder if he has his father and grandfather snowed or if they are in on the cover up, or maybe in denial. His parents work in medicine, his mother (former addict) is a nurse, his father is a paramedic, and his step mother is a non-practicing doctor. You’d think they would know the signs, then again maybe their positions allow them to cover it up and keep it in the family.
Does anybody know if it’s routine to test for drugs for pregnant women?
If it were my kid, I’d try to drag her back home. In the case of an addict, assume they are lying until proven otherwise.
ETA: families, even those made up of very smart people, can live in denial for a very long time. It’s easier than facing the truth and having to make difficult decisions.
Broomstick and Qadgop the Mercotan weighed in on the addiction side of things. As for the empty capsules, if the guy can’t swallow pills, he can ask his physician to call a compounding pharmacy to have the medication made up as a liquid. Or to order a liquid version.
Consequences of this sort of situation vary as well - even if mom isn’t using, having an active addict in a household can result in all sorts of complications, including in extreme cases removal of children from the household by authorities or tragic occurrences.
I agree with you Grumpy, she needs to get her daughter out of there. Her daughter is only 17 so she still has some authority. Getting her to use it another story.
She has been turning herself inside out for the last nine months trying to please everybody and she is turning into mush.
I told my friend that Broomstick. She knows and has told her daughter the same.
She says that drug screening is part of her regular checkups, but I don’t know. She takes her daughter to the appointments but she doesn’t go in with her. Her daughter could be telling her anything.
Is methadone also used for pain management? I had a neighbor once who was a 40-ish crazy-ish female who once begged me to drive her to the methadone clinic for her daily fix. She said she was on methadone for pain management (plausible as far as I knew, since she did have some kind of chronic progressive medical problem). But she was so borderline-crazy, it seemed just as plausible that she was an ex-addict.
Is her story (methadone for pain management) plausible?
Even if his story was 100% legit - and it’s not - it doesn’t explain why his apartment looks like a shooting den. Why does he leave the used paraphernalia all over the place instead of cleaning it up? How does Girlfriend plan to keep her child safe when he starts crawling in another six months?
If she’s still in that house after the baby’s born, I would think seriously about getting social services involved.
Whether or not the testing is being done, you or your friend can call DCFS and report the observed situation. Unfortunately, this is probably the most sensible course of action at this point.
Yes. I prescribe it for pain, mainly malignant pain (from cancer and other progressive painful diseases) and it’s quite a great long-acting potent pain killer. BUT it’s very tricky to dose and titrate due to its very long-acting nature, and more inadvertent deaths come from methadone than any other opioid. I’ve had a few near misses in my patients so have been shying away from it for that purpose, preferring long-actin morphine, fentanyl patches, or less often the new version of long-acting oxycodone which is less abusable than the old version.
Rule of thumb: If the patient has to get their dose of methadone daily at a clinic, the methadone is being used for treatment/maintenance of opioid addiction. If they have a month’s supply of it at home at a time, it’s being used for pain. Theoretically.
The patient must consent to drug screening, unless it is court-ordered. Which often does happen if the patient has run afoul of drug laws in the past, been convicted, and is mandated by their sentence structure to provide samples on request (generally of their parole/probation agent, though. NOT their doctor.)
A doctor may advise that the patient submit a urine sample to drug screen if they are monitoring clinical diseases like addiction or evaluating for other possible disease/metabolic states, or monitoring compliance with a pain treatment plan. If the patient refuses, the doctor may then decide to dismiss them as a patient, or stop prescribing them certain drugs, or both.
If a woman is pregnant AND addicted to opioids, it is very important to NOT put the developing fetus through withdrawal. Doing so would be a bad thing. So the woman in such a state is usually maintained on methadone or buprenorphine until she delivers, then the newborn is gently withdrawn from opioids with close monitoring, and the mom can be withdrawn at that time too.
I used to do obstetrics, but my only involvement with pregnant women at this point is to maintain opioid addicted ones on buprenorphine until appropriate to d/c it.